"I binge continuously all day long. I can't control myself. I've stopped seeing friends and I spend my time alone - eating. I hate how I look, but I have no control over my eating." - Peter, p3.

"Once I eat something, I figure that's it. I may as well go all the way I feel awful afterwards. I'm so ashamed of my eating; it just proves that I can't do anything right." - Meredith, p4.

These descriptions from people with disordered eating illustrate the lack of control and the self-hatred that goes with binge eating, and its destructive effect on the entire lives of those who are afflicted with this problem. Not only does it severely reduce self esteem and confidence, but it can ruin work, family and social lives.

The good news is that it is possible for many sufferers to change the beliefs, patterns of thoughts and habits that cause binge eating and to maintain in the long term a healthy weight and acceptable eating pattern. Binge No More is a self-help book which sets out to explain and implement techniques from two of the most popular strategies for dealing with disordered eating: cognitive behavioral therapy and interpersonal therapy.

The book is divided into two parts. The first part contains information to help with understanding disordered eating. It describes categories of problems with eating, who is likely to have these problems, the complications associated with the problems, and possible causes, including biological as well as psychological factors.

The second part, which accounts for about 60% of the book, is about how to overcome problems with disordered eating. It begins, logically, with an assessment exercise to find out what your eating patterns are, and discover the triggers that appear to lead to bingeing. The rest of the section is about changing behavior: changing your eating patterns directly, recognizing and overcoming negative self talk or "automatic thoughts", working out how to accept a less than perfect body shape, and coping with unpleasant emotions such as stress and shame. These are primarily cognitive behavioral therapy techniques, but there is a detailed section on interpersonal effectiveness, which is based on interpersonal therapy. The section concentrates mainly on dealing with conflicts, or "role disputes" in relationships, and includes a sub-section on assertive behavior. The book ends with a section on how to recover from backsliding.

There is a great deal of material in the book. It is well explained, and has obviously been well researched. The multitude of methods could be encouraging for the reader: "I thought there was nothing I could do about this problem - but now I see there are all these different things I can try!" On the other hand, the choice could leave the reader feeling overwhelmed and baffled. Although there are some indications in the assessment chapter about how to find your problem areas and choose an appropriate method, it is not clear whether the chapters are meant to be worked through in order, or simultaneously, or whether the reader should decide which one is most relevant and do that one first, and go on to one of the others if it isn't working. Since binge eating can be, for some people, associated with difficulty in making decisions, I can see that there might be some problems here! Having said this, the general style within the sections is authoritative and unambiguous. There is no doubt about why a technique will help, and how to put it into practice.

Although the book is practical and clear in its structure, there is a strong academic emphasis running right the way through it. For example, I felt that the attempt to define and distinguish between "eating disorders" and "disordered eating" in chapter 1 was unnecessary and rather confusing, especially as the terminology did not seem to be consistently applied. (The reason for the terminology is that eating disorders are clinically defined, but people do not need to meet diagnostic criteria in order to have a problem; e.g. someone may show anorexic tendencies while maintaining a weight that is only slightly below normal). After each chapter there is an impressive list of references, mainly from clinical journals. There are 76 of these after chapter 4, "The causes of disordered eating".. As an academic, I applaud such thoroughness; I do, however, question the need for them in a self-help book, since the average reader is unlikely to have the time to follow them up. A list of references at the back of the book to satisfy the academics would probably have been adequate, and it might have been helpful to suggest a small number of books for further reading at the end of each chapter instead of the references.

On balance, I liked this book. It is down-to-earth, sympathetic without being sentimental, and above all, helpful. I think it would be hard for someone to use the book as the sole source of help, however, because of its lack of a clear strategy. It would be most useful in conjunction with a plan obtained, for example, from another book or a therapist; it would then be able to give in-depth information and background to help motivation and understanding.

Natalie Simpson is a mathematics graduate of Oxford University, England, and holds a diploma in hypnotherapy. She developed an interest in psychology, psychotherapy and hypnosis after experiencing hypnotherapy herself. Her specific concerns include the assessment of the effectiveness and risks of psychotherapy, and the difficulties of obtaining informed consent of clients.

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